Specific microRNAs and heart failure: time for the next step toward application?

Abstract

A number of microRNAs are involved in the pathophysiological events associated with heart disease. In this review, we discuss miR-21, miR-1, miR-23a, miR-142-5p, miR-126, miR-29, miR-195, and miR-499 because they are most often mentioned as important specific indicators of myocardial hypertrophy and fibrosis leading to heart failure. The clinical use of microRNAs as biomarkers and for therapeutic interventions in cardiovascular diseases appears highly promising. However, there remain many unresolved details regarding their specific actions in distinct pathological phenomena. The introduction of microRNAs into routine practice, as part of the cardiovascular examination panel, will require additional clinically relevant and reliable data. Thus, there remains a need for additional research in this area, as well as the optimization and standardization of laboratory procedures which could significantly shorten the determination time, and make microRNA analysis simpler and more affordable. In this review, we aim to summarize the current knowledge about selected microRNAs related to heart failure, including their potential use in diagnosis, prognosis, and treatment, and options for their laboratory determination.

Circulating miRNA-451a and miRNA-328-3p as Potential Markers of Coronary Artery Aneurysmal Disease

“…Since the presence of miRNAs in plasma was first mentioned in the literature, circulating miRNAs have been reported as a potential biomarker of heart failure and CAD [ 23 , 28 ]. In contrast to the numerous studies in CAD cohorts, the predictive value of miRNAs in CAAD is yet to be discovered.…”

Heart Failure: Is There an Ideal Biomarker?

“…Therefore, given this variety of expression, miRNAs have been taken into consideration in the most common cardiac pathologies, such as acute myocardial infarction, atrial fibrillation, and HF, in order to establish their possible role in the pathogenesis or evolution of these disorders. In HF patients, miRNA 21 (miR-21), miR-1, miR-23a, miR-142-5p, miR-126, miR-29, miR-195, and miR-499 were found to be the most frequent miRNAs associated with conditions such as hypertrophy heart and fibrosis leading to the development of the pathology itself [ 106 ]. In a recent meta-analysis, miRNAs demonstrated good sensitivity and specificity in identifying patients with chronic HF, albeit not superior to conventional markers (NT-proBNP and BNP).…”

“…From the listed studies, it is clear that the current and, above all, future possibilities of using miRNAs in the clinic are many and of great interest as they can be able to define clusters of patients with certain clinical characteristics as well as being a valid aid in the diagnosis and in the prognosis of patients with HF together with classical markers. MiRNAs also represent a possible future therapeutic target with the possibility of altering the physiological or pathological processes in which they play a central role, thus inhibiting their expression or, on the contrary, synthesizing molecules that can camouflage their role [ 111 ]. However, there are currently numerous limitations to the use of miRNAs, such as their overlap in various cardiac pathologies, the difficulties of isolation and sampling, the lack of normalized parameters, and the high costs which currently make their routine use difficult.…”